Rizwan fizal R

176
 Defenition
 Stages
 Hormoanes involved
 Mechanism
 Abnormal cases
 Parturition means expulsion or delivery of fetus from mothers body.It occurs at the
end of pregnency
 The process by which delivery of the fetus happens is known as labor
 Stage 1:- Dilatation of the cervix
 Stage 2:- Delivery of the fetus
 Stage 3:- Placental delivery
 Estrogen Progesterone ratio
- Progesterone inhibits the uterine contractility by inhibiting enzyme phospholipase A,
which is necessory for synthesis of prostaglandins
- conversely estrogen increases the degree of uterine contractility by increasing the gap
juctions of adjacent uterine smooth muscles‘also increases the oxytocin receptors in
uterine wall
- This ratio of estrogen to progesterone increases towards the end of pregnancy
 Oxytocin
- It is secreted in neurohypophysis
- There are 4 reasons which are believed for the increase in the uterine contractions
1.For increase in the receptores on uterine wall
2.For the increase in rate of secretion at the time of labor
3.Prolonged labor in hypophysectomised animals
4.Neuroendocrine reflex
 Relaxin
- It is secreted in large quantities by placenta during labor
- It softens the cervix ,loosening the ligaments of symphysis pubis
- It suppresses the action of progesterone
- It increases the oxytocin receptors
 prostaglandins and catecholamines
- Increases the uterine contractions
 Cortisol
- Helps the mother to withstand stress during labor
- Its starts with false labor
- It begins from Uterine fundus and spreads over the body
- Intensity is great at the top and less at lower segment
- In early stage occurs once for every 30 mins,and increases to once in every 1-3
mins
- combines contraction causes force of 25 pounds for each contraction
- In more than 95% births head is expelled first
- First obstruction is the uterine cervix
- Dilation of cervix through positive feed back mechanism (8 to 24 hrs)
- Fetus moves into birth canal (1 to 30 mins)
- After delivery contraction reduces separating placenta from its site (10 to 30 mins)
- Bleeding limited to average of 350 milliliters
 Labor pains
- Pain in early stage is Less ot not felt
- Pain in 2nd stage is severe
 Premature delivery
 Placental abruption
 Abnormal position of fetus
 Cord prolapse
 Cephalo pelvic dispropotion